The Association of Age at Immigration with Endorsing Feeling Depressed Among Immigrant Adults in the US

Background: Evidence for immigrant health is mixed and may partially be explained by underreporting or underdiagnosis of depression symptoms. Acculturation, the process of assimilating to a cultural environment, may impact depression symptom recognition and reporting through various mechanisms, including an underexplored but important factor, age at immigration. Those who immigrate at a younger age tend to acculturate more easily to the dominant culture. Using National Health and Nutrition Examination Surveys from 2015 to 2018, we investigate whether age at immigration is associated with endorsing face-valid depression severity among a sample of immigrant adults in the US. Methods: Conceptualized as an explicit admission of depression, the face-valid depression question asked, “How often do you feel depressed?” (i.e., daily, never). Age at immigration was derived by subtracting the number of years lived in the US from the current age and then dummy-coded into 15-year increments with 0-15 years as the referent. Controlling for the PHQ-9 scores, a validated measure of depression, accounted for individuals who endorsed clinical depression. Three linear regressions and a supplementary model tested the association of age at immigration with endorsing face-valid depression severity, controlling for sociodemographics. Results: Of the sample of 2,632 respondents, 51.6% female, 35.4% Asian, 27.7% Mexican American, 23.3% Other Hispanic, 6% Black, 5% White, 1.7% multiracial/other, the mean age at immigration was 29.52 years (ranging 0-79). Over half (52.7%) endorsed never feeling depressed, whereas 3% endorsed feeling depressed daily on the face-valid depression question. Only the covariates, being neither married/living with a partner and higher PHQ-9 scores were significantly associated with higher face-valid depression severity. Discussion: After full adjustment, age at immigration was not found to be associated with face-valid depression severity endorsement. It is also important to note that we conceptualized the face-valid depression severity question as an explicit admission of depression severity, but respondents may not have. It’s possible that this question was not designed to capture “admission” as a construct. However, understanding which factors influence immigrants' self-recognition and reporting of mental health concerns remains essential to striving toward equitable, accessible mental health care systems.

Author dc:creator

• Clare Wongwai (24399545)

• Psychology, Clinical
• Health Sciences, Mental Health

Statement dc:rights

• In Copyright

DOI dc:identifier

https://doi.org/10.25417/uic.32993984.v1

OAI identifier oai:identifier

oai:figshare.com:article/32993984